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Fraud

Fraud hurts everyone. It penalizes honest employers and employees by raising rates and taxing the system. Workers’ compensation fraud is a serious offense – fraudulent activity that exceeds $2,000 is a felony. Workers’ compensation fraud can be committed by employers, employees, lawyers, insurance company personnel, physicians, medical providers, and other stakeholders in the system.

Preventing fraud is part of our mission and we take it very seriously.

If you suspect anyone of abusing the workers’ compensation system, please call HEMIC’s Fraud Hotline or fill in the email form below. Fraud tips may remain anonymous. We will investigate any reasonable tip, providing the information to the proper authorities if our investigation reveals a provable fraud case.

The most common kinds of fraud are employee and employer frauds. Employee fraud usually entails misrepresenting when, where, or how an injury occurred, faking injuries, symptom exaggeration, malingering, or some combination of those abuses. Employer fraud, also known as premium fraud, involves unreported cash payrolls, misclassification of payroll, bogus subcontractor schemes, or other efforts to conceal or misrepresent payroll, the basis for workers’ compensation premium. Employer fraud may include improper manipulation of the experience rating system.